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CMS Issues Temporary Policy For Marketplace Premium Reductions

The Centers for Medicare & Medicaid Services (CMS) on Aug. 4 issued a temporary policy to allow premium credits for health plans offered in the individual and group markets. The agency is using its discretion to allow these credits to support continuity of coverage for individuals and families impacted by the COVID-19 public health emergency and facing difficulties paying premiums.

To offer premium credits, health plan issuers must receive permission from state regulators or CMS. Issuers that offer qualified health plan coverage on either the federally facilitated or state-based marketplaces also must obtain permission from the marketplace through which the plan is offered. Credits must be applied uniformly, regardless of whether the plan is offered inside or outside a marketplace, and through the end of the 2020 calendar year.

CMS plans to release additional guidance and a template for issuers interested in providing these premium credits. The template will provide information about the premium credits to comply with existing reporting requirements. Templates will be due to CMS by Oct. 1.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Gontscharow is a senior policy analyst for America's Essential Hospitals.

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